The truth about stretching and physical therapy

Many people believe that sports physical therapy and performance training should involve a significant amount of stretching. However, every aspect of injury rehabilitation or athletic training needs to serve a clear and specific purpose. When was the last time you paused and asked yourself, “What do I hope to gain from stretching this area?” or “Does this particular muscle even need to be stretched?”

The truth is, like most things in physical therapy, the answer isn’t black and white—it depends. To understand whether stretching is appropriate, you first need to know why a muscle has become stiff or tight in the first place.

Why Do Muscles Become Stiff?

Muscles can become stiff when they are held in a shortened position for extended periods of time. For example, if you spend most of your day sitting or standing in the same position, your muscles may “lock up” in that position and feel tight. Another common cause of stiffness is repetitive movement—when you continually perform the same motions without incorporating enough variety into your routine.

So, if your day involves repetitive tasks or being in a static posture for hours on end, stretching might temporarily relieve the stiffness, but it won’t address the root cause. The solution to “tight” muscles often lies in incorporating more varied movement into your daily routine.

Stretching Without Purpose: A Common Mistake in Physical Therapy

One of the biggest misconceptions in physical therapy is that stretching is always the answer to stiffness or discomfort. However, stretching a muscle without addressing the underlying reason it became stiff is like putting a bandage over the problem—it may help in the short term, but it won’t fix the issue.

For example, in many cases, a muscle might become stiff to protect the body from injury. This is particularly common with back pain. When your back muscles tighten up, they are often responding to underlying instability or strain in the spine. Stretching those muscles could actually make the problem worse by compromising the body’s natural protective mechanisms, increasing your risk of injury.

A Smarter Approach to Stretching in Physical Therapy

Next time you think about stretching a stiff muscle, ask yourself this important question: “Why is this muscle stiff in the first place?” In physical therapy, we focus on identifying and treating the root cause of muscular tightness, rather than just addressing the symptoms. Often, incorporating more variety into your daily movements or addressing imbalances through targeted exercises is a far more effective approach than simply stretching.

Remember, physical therapy is about **rehabilitation with purpose**. Instead of stretching without knowing why, work with a physical therapist who can help you identify the root cause of stiffness and develop a plan to address it safely and effectively. This will not only help you overcome your current discomfort but also reduce your risk of future injuries.

The first drills that we teach to youth athletes

It is essential to understand the demands placed onto the body when working in a sports physical therapy, injury rehabilitation, and performance training setting.

Sports and weight training require athletes to control the body when moving rapidly.

If an athlete wishes to own the “stack” (stacking of our head, rib cage and pelvis over one another) and protect their lower back they must be capable of doing so when performing high velocity movements.

When youth athletes first train, we use medicine ball drills to teach this ability.

The medicine ball chest pass is a great drill to teach this capability. During this the drill, the athlete is generating enough velocity to propel the ball into the wall and back. As this occurs, it can be easy to lose the “stack” requiring the athlete demonstrate a higher of level of body control.

After mastering the chest pass, it is time to bring the arms overhead. More trunk strength and control are required with this movement and the ability to manage intra-abdominal pressure is further challenged. Check out this exercise here.

These are just a couple of the exercises that we incorporate into the training sessions and warmups for our youth athletes.

If you interested in learning more about the summer training options for youth athletes at CHP,  please contact us!

Is Your Doctor (or physical therapy clinic) Taking Care of You?

Recently, I joined my mother-in-law for a visit to a physician’s office.

The physician she saw has a solid reputation and is known as a “go-to” expert in his field.

During the visit he spent a total of 5 minutes with my mother-in-law, glossing over test results and providing very brief recommendations.

He appeared to be speaking as fast as he could so that he could finish the visit and to get to his next patient. After his rushed explanation, we attempted to ask questions, which he answered while backing out of the room.

Sadly, experiences like this are very common in the world of healthcare and I do not blame the healthcare providers because they oftentimes are not left with much of a choice.

The health insurance industry consistently reduces reimbursement to health care providers, forcing them to schedule more patients within a fixed time period. As a result, the quality of care suffers, and everything becomes less personalized.

This also occurs in physical therapy, forcing many clinicians to resort to “cookie cutter” protocols.

If you go to Physical Therapy because of lower back pain then you get put on the lower back pain protocol, shoulder pain=shoulder protocol, etc.

Many times, this works, however, it is not the best choice for those looking to live an active, pain free, and healthy life.

For this reason I typically seek out practitioners that are out of network with health insurance as it enables them to provide me with the highest quality of care possible. In this approach I am treated like an individual and I get to ask all the questions that I would like so that I can a better understanding of my health.

We are out of network providers here at Cohen Health and Performance. We strive to get the best possible results for our patients in the least number of visits, while also providing the education necessary to prevent future issues from occurring.

People can feel better, move better, and enjoy an active lifestyle.  Our mission at CHP will always be to take the best possible care of our patients and that is why we are out of network with health insurance.

Interested in learning more about how this approach can help you? Contact us here!

What All Rotational Athletes Must Be Capable Of

Low back pain with golf or arm pain with throwing. At our performance physical therapy practice, we see this constantly. 

Swinging a golf club, throwing a baseball and hitting a tennis ball involve a great deal of rotation. Many areas of the body should be involved in these movements, however that is not always the case.

It is common to see baseball pitchers that are experiencing arm issues demonstrate the habit of trying to “arm” the ball as they throw it. There is not much contribution from the legs which places a great deal of stress on the arm and over time results in overuse injuries. 

Many golfers and tennis players experience lower back pain because they do not effectively link the power that they generate in the lower body through the trunk, into the upper body and ultimately to the head of the club. As a result they compensate elsewhere, placing increased stress onto the lower back.

The rotational row is a great drill to train the body to generate rotational power through the legs and connect it through the trunk. View this exercise here.

Once you have mastered the rotational row and learned how to link the power generated in the lower body to the trunk, we can now add in the upper body! The rotational lift trains the body to generate rotational power through the legs and connect it through the trunk and arms. Check this exercise out here.

Interested in learning more ways you can address lower back pain while enjoying your active lifestyle? Sign up for a FREE phone consultation today!

We Are Expanding!!

We are expanding!

CHP-McLean is opening this summer in McLean, Virginia! We are so excited for the opportunity to further spread our mission of helping injured athletes and active adults to overcome the injuries that limit their active lifestyles.

Our 2700 square foot, state of the art space will be used to deliver the high-level sports physical therapy and performance training that you have come to expect from us in Bethesda.

However, that is not all! We will also be offering small group training to high school athletes. If you are a high school athlete or the parent of one, this is a can’t miss opportunity to get stronger, faster, and take your performance to the next level.

CHP-McLean is being built out now and is expected to open in late July 2022. Follow the @cohenhealthandperformance instagram page for continued updates on our buildout and grand opening!

We hope to see you there!

Secret to Avoiding Running Related Hamstring Injuries

Many runners and other athletes, like you, understand that strength training improves performance, reduces injury risk and decreases the likelihood that you will see us in physical therapy!

However, we have found that you may be strength training because you feel that you are supposed to but these workouts are more than simply checking a box.

It is important to think about how you are training a particular muscle group during your workout. This change in focus may be the secret to eliminating future hamstring injuries that cause many to look for a physical therapist.

Many people strengthen the hamstrings in a concentric (as the muscles shorten) fashion, however most hamstring strains occur as the muscles lengthen and work to slow down the swinging leg.

It is essential for any runner or athlete that performs a great deal of sprinting to develop a large amount of eccentric (muscle contraction that occurs as it lengthens) hamstring strength.

Eccentric hamstring curls are a great way to build this quality and the double leg variation on a physioball is a great place to start! Click here to see this exercise.

Once you have mastered the double leg eccentric glute bridge, it is time to step things up to the single leg progression.

How do you know if you are ready to move on? A great goal to shoot for on the double leg version is 10 FULL repetitions with a full 5 second lengthening period on each rep. The hips should not be dropping, and you should feel your abs throughout the set!

As we continue to build eccentric hamstring strength, this drill will add some additional challenges.

One leg will be flexed with the hip and knee at 90 degrees, mimicking a sprinting position. The result is one hip in a position of flexion while the other is in extension, much like sprinting or running. This will challenge your ability to control the position of the pelvis as you demonstrate hamstring strength.

Click here for the single leg progression!

Once you have mastered the single leg eccentric hamstring curl on a physioball, you can progress even further. To learn how to do that amongst other ways to optimize your strength training, click here.

Also, don’t forget to follow us on Instagram and facebook @cohenhealthandperformance!

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